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General NPI Number Information
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NPI Number | 1912128075
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Entity Type | Organization
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Legal Business Name | EVESHAM TOWNSHIP FIRE DISTRICT NO 1
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 08/12/2020
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Provider Practice Location Address
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Address Line | 984 TUCKERTON RD
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City | MARLTON
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State | NJ
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Zip | 08053-2652
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Country | US
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Telephone | 856-983-2750
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Fax |
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Provider Business Mailing Address
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Address Line | 984 TUCKERTON RD
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City | EVESHAM
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State | NJ
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Zip | 08053-2652
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Country | US
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Telephone | 856-983-2750
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MAUREEN MITCHELL
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Credential |
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Telephone | 856-983-2750
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | EVES00198
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License Number State | NJ
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